Long-Term Impact of a Community Health Worker Intervention on Diabetes Control in American Samoa.

摘要: INTRODUCTION Diabetes Care in American Samoa (DCAS) was a randomized controlled trial of 12-month intervention facilitated by community health workers (CHWs) that demonstrated improved HbA1c levels compared with usual care at completion. We sought to evaluate the long-term impact this on diabetes control. METHODS retrospectively collected measurements from medical records DCAS participants (n = 268). The study group received during trial, and control after trial. used mixed-effects longitudinal regression models assess change within each arm 3 time periods: (12 months group's intervention), first year (control second DCAS. Models were adjusted for baseline characteristics differed significantly low number those high measurements. RESULTS After adjustment confounders, experiment experienced decrease 0.28 units per (95% confidence interval [CI], -0.64 0.07) (intervention). decreased 0.88 CI, -1.31 -0.45) intervention. No significant observed following year. did not (usual care) but 1.31 -1.72 -0.91) its During intervention, increased 1.18 0.42 1.93). CONCLUSION Both groups had initial improvements glycemic control, later plateaued or increased. These results suggest time-limited CHW programs improve short term, ongoing are needed sustained impact.